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WELD COUNTY ROAD ACCESS INFORMATION SHEET
Weld County Department of Public Works
• 111 H St PO Box 758 Greeley CO 80632
Phone: (970) 356-4000 x3750 Fax: (970) 304-6497
Road File#: Date:
RE#: I Other Case #:
1. Applicant Name RA55eit L. a 4-Hc o. E. (_.^� 111O it Phone 970 -' 785-2123
Address /9995/ Cagyll jjoa 3ry City Fla-I-fey Ile State CO Zip e0(o5I
2. Address or Location of Access /9y 9'l Ce n 4-y Rd 3 t'
Section 01 Township e, 3 Range to to Subdivision — Block — Lot A
Weld County Road #: 3b Side of Road Sect+IN Distance from nearest intersection y2 m;►e
3. Is there an existing access(es) to the property? Yes X No #of Accesses
4. Proposed Use:
LVPermanent UK Residential/Agricultural ❑ Industrial
O Temporary ❑ Subdivision Cv Commercial ❑ Other
5. Site Sketch
Legend for Access Description: I I
AG = Agricultural
t ouv�� d 3(p
RES = Residential
O&G = Oil&Gas ns
D.R. = Ditch Road
0 = House
• = Proposed Access
= Existing Access
M �
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LDCIh I ' . .3ti.......................................
OFFICE USE ONLY:
Road ADT Date Accidents Date
Road ADT Date Accidents Date
Drainage Requirement Culvert Size Length
Special Conditions
O Installation Authorized O Information Insufficient
Reviewed By: Title:
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